Vol 174, No 2 (2015)
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MEMORABLE DATES
THE GALLERY OF NATIONAL SURGEONS
PROBLEMS OF GENERAL AND SPECIAL SURGERY
G. G. Khubulava,
V. N. Kravchuk,
E. A. Knyazev,
A. N. Shishkevich,
A. S. Peleshok,
A. S. Kusai,
A. E. Sukharev,
A. I. Lyubimov
20-24 531
Abstract
The article provides the results of minimally invasive direct revasculization of myocardium at the period from 2012 to 2014. Given method was used in 49 interventions. There weren’t any lethal cases or myocardial infarctions. A mean hospital stay consisted of 8,6±2,7. Computer thomographic coronary bypass angiography was carried out after operation in terms of 6-48 months. The occlusion of mammary coronary shunt was revealed in 3 patients with minimally invasive revasculization of the myocardium in terms up to 48 months. There were noted a decrease of hospital stay, bleeding during surgery and in early postoperative period, duration of artificial pulmonary ventilation, length of stay in intensive care unit for this group of patients.
D. N. Maistrenko,
M. I. Generalov,
P. G. Tarazov,
F. K. Zherebtsov,
V. V. Osovskikh,
A. S. Ivanov,
A. N. Oleshchuk,
D. A. Granov
25-29 532
Abstract
The authors analyzed the single-center experience of treatment of 72 patients with abdominal aortic aneurisms and severe accompanied pathology. The aneurisms were repaired by stentgrafts. All the patients had abdominal aortic aneurisms with the diameters from 41 to 84 mm against the background of severe somatic pathology. It was a contraindication to planned open surgery. An installation of stent-graft was successful in all 72 follow-ups. It wasn’t necessary to use a conversion to open surgery. The follow-up period consisted of 44,6±2,1 months. Control ultrasound and computer tomography studies hadn’t revealed an increase of aneurism sack sizes or «leakages». A reduction of abdominal aortic aneurism sizes was noted in 37 patients on 4-5% during first year after operation. The stentgraft implantation extends the possibilities of abdominal aortic aneurism treatment for patients from a high surgical risk group.
VALUE OF ANATOMICAL INTRACRANIAL RESERVE IN SURGICAL TREATMENT OF INJURIES AND DISEASES OF THE BRAIN
30-32 449
Abstract
The authors proposed to evaluate the quantity of anatomical intracranial reserve according to morphometric measurements in axial projection by means of helical computer tomography data of bitemporal distance, width of the tentorial opening, diameter of the foramen magnum and mutual correlation of these parameters in points. This method showed a high accuracy (92%) and predictive value (85%) in determination of terms and volume of complex treatment of 140 victims with craniocerebral injury, 120 patients with primary tumors of the brain and 110 patients with acute disorder of cerebral circulation.
S. A. Alent’Ev,
B. N. Kotiv,
S. Ya. Ivanusa,
P. N. Zubarev,
I. I. Dzidzava,
D. P. Kashkin,
A. L. Muzharovskiy
33-38 522
Abstract
The article presents the results of endovascular treatment of 35 patients with Budd-Chiari syndrome. An analysis of efficacy of modern interventions was made. There were shown the possibilities of balloon dilatation of stenosis of renal veins, the balloon dilatation and stenting with metal self-expansible stents of stenosis an occlusion of intrahepatic section of the postcava and results of transhepatic portsystemic bypass surgery.
39-41 489
Abstract
A medical trend which is currently gaining strength includes the complex treatment based on the concept of «fast-track» recovery in oncology. An application of modern high-tech approaches allowed minimizing the terms of treatment, shortening economic costs and getting the highest final results. It provides a high quality treatment. Given method could exclude an interim treatment stages, sufficiently reduces terms of general treatment and rehabilitation of patients and could succeed in high quality of life for the patients in short- and long-term period. The authors present the results of successful clinical surgery of 78 patients using this method in public health.
42-46 1318
Abstract
The authors have launched a prospective randomized study aimed to make a comparison of functional results of formation of straight coloanal (control group) and side-to end (main group) anastomosis in case of low anterior rectal resection since 2012. Each group consisted of 40 patients undergoing operation concerning uncomplicated rectal cancer of medium-ampullar section of rectum. It was noted that patients of the main group had lower stool frequency in postoperative period. A function of the interior sphincter was less damaged and the rate of compliance of rectum was high.
A. S. Ivanov,
D. N. Maistrenko,
M. I. Generalov,
F. K. Zherebtsov,
A. N. Oleshchuk,
D. A. Granov,
A. V. Gusinskiy,
I. V. Mikhailov
47-51 483
Abstract
The article presents an analysis of treatment results of 91 patients with iliac-femoral segment artery occlusion at the period from 2008 to 2014. Patients were divided into 2 groups: main group (n=30) consisted of patients who undergoing a half-closed loop endarterectomy with following implantation of stent-grafts in this area and control group (n=61) had patients whom were performed routine half-closed loop endarterectomy. The II degree of ischemia of lower extremities was in 88 (96,7%) patients and III degree had 3 (3,3%) patients. The areas of abnormalities of intravascular pattern were detected in 100% of cases in intraoperative angiography. They were modified using stent-grafts. A primary vascular patency was 100% in the first group and it numbered 65% in the second group during 5 years. The intraoperative angiography control with stent-graft implantation to the area of endarterectomy allowed reliable improvement of treatment results.
SURGERY OF INJURIES
52-56 362
Abstract
A case report presents the experience of application of compression pileateless mini-screws (Gerbert’s screws) in treatment of intra-articular fractures, which formed the elbow joint (44 cases). There were performed 32 operations concerning fracture of head of radius, 10 operations on the occasion of fractures of distal section of the humerus and 2 operations on the coronoid process. Long-term treatment results were followed-up in 31 patients during more than 6 months. On basis of analysis of treatment results the authors made a conclusion that the application of mini-screws in case of bone fractures, which formed the elbow joint, allowed realization of stable osteosynthesis after anatomic reposition of articular surfaces, obtaining good anatomical and functional result and shortened the terms of patient’s treatment.
57-62 661
Abstract
The article based on the analysis of 84 follow-up of the patients. The authors suggested using the indices of microbiological and immunological investigations and data of laser Doppler ultrasonography to determine the readiness of granulating wound to free autoplasty. The data obtained allowed developing an algorithm of treatment, patient’s preparation to surgery and determination of operation terms.
SURGERY IN CHILDREN
N. A. Borisova,
I. A. Komissarov,
S. V. Gol’Bits,
M. I. Komissarov,
A. S. Ilyin,
I. Yu. Aleshin,
D. R. Nugaeva
63-69 630
Abstract
Children with acute pulmonary bleeding (8 cases) due to different pathology of trancheobronchial tree were followed-up at the period from 2008 to 2014. Diagnostic angiography and X-ray endovascular occlusion of bronchial arteries were performed in the case of insufficiency of conservative and endoscopic methods of hemostasis. Microembolic spheres were used for embolization of distal vessels. The embolization coils and micro-coils were applied for occlusion of great vessels. Children (5 cases) were discharged from the hospital after embolization at the terms of 6-12 months. They hadn’t any ischemic complications associated with bronchial artery occlusion. The sequelae of main disease caused deaths of 3 other kids. The X-ray occlusion is a low-invasive and highly effective method of arrest of all types of bleeding from pool of bronchial arteries. The method could be applied even in extremely severe condition of the patients.
SURGERY OF ORGANS OF ENDOCRINE SYSTEM
70-76 533
Abstract
The authors studied the long-term results of surgical treatment of 949 patients with thyroid carcinoma. The malignant tumors of other organs were revealed in 55 (5,8%) cases during 20 years of follow-up. It was stated that patients with thyroid carcinoma had a higher risk of developing other malignant tumors than in population. A typical background for onset of other neoplasms was a latent hypothyroidism, hyperlipidemia, hypersecretion of gonadotropins, an influence of occupational hazard of chemical nature and hereditary load of oncology.
77-80 475
Abstract
The article is based on the treatment results of 44 patients with follicular tumor of thyroid gland. A staged morphological assessment of thyroid nodes was performed for all patients: in case of preoperative fine-needle biopsy, urgent intraoperative study and according to results of final histological research. The urgent histological study of surgical material was conducted for 44 patients with diagnosis «follicular tumor» according to fine-needle biopsy. The data of final histological study were matched with findings of intraoperative research. A micro-follicular adenoma was detected in 22 patients (50%) and 6 (13,6%) patients had this diagnosis combined with autoimmune thyroiditis. The general part of patients didn’t changed in final study, but the rate of diagnosis «micro-follicular adenoma against the background of autoimmune thyroiditis» increased. Papillary carcinoma was revealed in 5 (11,4%) patients and follicular cancer had 4 (9,1%) patients detected in intraoperative study and 3 (6,8%) more patients according to data of final research. The histopathologic feature of colloid goiter was observed in 7 (15,9%) cases and a part of such patients reduced to 6,8% during final study. One of the patients (2,3%) had final diagnosis «oncocytoma». In case of thyroid nodules detection the needle biopsy should be carried out regardless to the size of nodule. The authors recommended performing the surgery with the urgent histological study in case of undetermined histological report. The following surgical strate gy was specified by the results of the urgent histological report.
81-83 427
Abstract
An investigation of galectin-3 and thyroglobulin using IFA was conducted in 80 patients. A lavage of aspirate from the thyroid gland was obtained by fine-needle aspiration biopsy. It was stated that significant increase of galectin-3 and thyroglobulin was noted in case of high differentiated thyroid carcinoma in comparison with benign nodules. Galectin-3 and thyroglobulin from the lavage of thyroid gland aspirate could be used as an oncological marker for complex differentiated diagnostics of high differentiated thyroid carcinoma and benign nodules.
EXPERIENCE OF WORK
Yu. V. Chervyakov,
I. N. Staroverov,
A. V. Borisov,
E. G. Nersesyan,
O. N. Vlasenko,
S. N. Lavlinskiy
84-88 436
Abstract
There are several ways of «indirect» revascularization such as revascularizated osteotrepanation of shinbone and lumbar sympathectomy (LS) for treatment of patients with chronic ischemia of lower extremities. They appeared to be sufficiently effective for the patients with II stage of the disease. Patients with critical ischemia (III stage) had persistent positive results after lumbar sympathectomy during 3-year period only in 33% of cases and using revacularized osteotrepnation - 46%. The difference in efficacy of treatment using LS and standard conservative therapy is statistically low significant, so that isn’t allowed recommending the sympathectomy for treatment of III stage ischemia. The method of revascularizated osteotrepanation of shinbone showed a reliably better result, therefore this way is reasonable to apply in surgery in case of III stage ischemia.
89-92 452
Abstract
The article estimated the results of excision of temporary loop colo- and ileostomas using method of their formation with fixation of parietal peritoneum to aponeurosis of abdominal external oblique muscle in 18 patients. The authors concluded that the formation of temporary loop stoma with fixation of parietal peritoneum to aponeurosis had many advantages and could improve the results of the restorative operation.
OBSERVATION FROM PRACTICE
MANAGEMENT OF SURGICAL WORK
106-109 402
Abstract
The author proposed to use a lumbar part of calf carcass as a new biological model for training of basic practical skills in order to perform the neurosurgical operative interventions on the spine. The proximity of anatomico-surgical parameters of given model and human cavader lumbar spine was estimated. The study proved the possibility of use of lumbar part of calf carcass for training techniques of transpedicular fixation and microdiskectomy in lumbar part.
SURGERY ABROAD
110-114 421
Abstract
The article analyzed the methods of suprapancretic lymph node dissection in laparoscopic gastrectomy which were developed and applied in Japan. The authors described the details of operation technique. There were noted the advantages of medial approach for suprapancreatic lymph node dissection.
HISTORY OF SURGERY
REVIEWS
ISSN 0042-4625 (Print)
ISSN 2686-7370 (Online)
ISSN 2686-7370 (Online)